﻿@model PlusAssistance.Models.ClientDetailModel

@{
    ViewBag.Title = "Index";
}


<div class="row">
    <div class="col-md-6">
        <fieldset><legend class="text-primary">Datos del Cliente</legend></fieldset>
        <div class="row">
            <form>

                <div class="col-md-4">
                    <div class="form-group">
                        <label for="CompletedName">Nombre Completo</label>
                        <input type="text" class="form-control" value ="@Model.CompletedName" id="CompletedName" readonly="readonly" placeholder="Nombre Completo">
                    </div>
                    <div class="form-group">
                        <label for="Dni">Cuil</label>
                        <input type="text" class="form-control" id="Cuil" value ="@Model.Cuil" placeholder="Cuil">
                    </div>
                    <div class="form-group">
                        <label for="Dni">Dni</label>
                        <input type="text" class="form-control" value ="@Model.Dni" id="CompletedName1" placeholder="Nombre Completo">
                    </div>
                </div>

                <div class="col-md-4">
                    <div class="form-group">
                        <label for="DateOfBirth">Fecha de Nacimiento</label>
                        <input type="text" class="form-control" value ="@Model.DateOfBirth.ToShortDateString()" id="DateOfBirth" placeholder="Nombre Completo">
                    </div>
                    <div class="form-group">
                        <label for="MaritalStatus">Estado Civil</label>
                        <select class="form-control">
                            <option>Soltero</option>
                            <option>Casado</option>
                            <option>Divorciado</option>
                        </select>
                    </div>
                    <div class="form-group">
                        <label for="Gender">Sexo</label>
                        <select class="form-control">
                            <option>Masculino</option>
                            <option>Femenino</option>
                        </select>
                    </div>
                </div>
                <div class="col-md-4">
                    <div class="form-group">
                        <label for="">Nivel Socio Economico</label>
                        <select class="form-control">
                            <option>Alto</option>
                            <option>Medio</option>
                            <option>Bajo</option>
                        </select>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="col-md-6">
        <fieldset><legend class="text-primary">Datos de tarjeta</legend></fieldset>
        <div class="row">
            <div class="col-md-6">
                <div class="form-group">
                    <label for="exampleInputPassword1">Numero de tarjeta</label>
                    <input type="text" readonly="readonly" class="form-control" id="CreditCardNumber" value ="@Model.CreditCardNumber"  placeholder="Numero de tarjeta">
                </div>
                <div class="form-group">
                    <label for="ZipCode">Fecha de Expiracion</label>
                    <input type="text" class="form-control" id="CreditCardExpiration"  value ="@Model.CreditCardExpiration.ToShortDateString()" placeholder="Fecha de Expiracion">
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label for="exampleInputPassword1">Tarjeta</label>
                    <input type="text" readonly="readonly" class="form-control" id="CreditCard" value ="@Model.CreditCard"  placeholder="Tarjeta de credito">
                </div>
                <div class="form-group">
                    <label for="ZipCode">Contact Id</label>
                    <input type="text" class="form-control" id="ContactId"  value ="@Model.ContactId" placeholder="Contact Id">
                </div>
            </div>
        </div>
    </div>
</div>

<br />
<div class="row">
    <div class="col-md-12">
        <fieldset><legend class="text-primary">Datos de Contacto</legend></fieldset>
    </div>
</div>

<div class="row">
    <div class="col-md-3">
        <div class="form-group">
            <label for="Province">Provincia</label>
            <select class="form-control">
                <option>Mendoza</option>
                <option>San Luis</option>
            </select>
        </div>
        <div class="form-group">
            <label for="Province">Localidad</label>
            <select class="form-control">
                <option>Godoy Cruz</option>
                <option>Capital</option>
            </select>
        </div>
    </div>
    <div class="col-md-3">
        <div class="form-group">
            <label for="exampleInputPassword1">Direccion</label>
            <input type="text" class="form-control" id="Address" value ="@Model.Address"  placeholder="Direccion">
        </div>
        <div class="form-group">
            <label for="ZipCode">Codigo Postal</label>
            <input type="text" class="form-control" value ="@Model.ZipCode" id="ZipCode" placeholder="Codigo Postal">
        </div>
    </div>
    <div class="col-md-2">
        <div class="form-group">
            <label for="exampleInputPassword1">Telefono 1</label>
            <input type="text" class="form-control" id="Telephone1" value ="@Model.Telephone1"  placeholder="Direccion">
        </div>
        <div class="form-group">
            <label for="ZipCode">Telefono 3</label>
            <input type="text" class="form-control" id="Telephone2"  value ="@Model.Telephone2" placeholder="Codigo Postal">
        </div>
    </div>
    <div class="col-md-2">
        <div class="form-group">
            <label for="exampleInputPassword1">Telefono 2</label>
            <input type="text" class="form-control" id="Telephone3" value ="@Model.Telephone3"  placeholder="Direccion">
        </div>
        <div class="form-group">
            <label for="ZipCode">Telefono 4</label>
            <input type="text" class="form-control" id="Telephone4"  value ="@Model.Telephone4" placeholder="Codigo Postal">
        </div>
    </div>
    <div class="col-md-2">
        <div class="form-group">
            <label for="exampleInputPassword1">Fax 1</label>
            <input type="text" class="form-control" id="Fax1" value ="@Model.Fax1"  placeholder="Direccion">
        </div>
        <div class="form-group">
            <label for="ZipCode">Fax 2</label>
            <input type="text" class="form-control" id="Fax2"  value ="@Model.Fax2" placeholder="Codigo Postal">
        </div>
    </div>
</div>

<br />

<div class="row">
    <div class="col-md-6">
        <fieldset><legend class="text-primary">Otros Datos</legend></fieldset>
        <div class="row">
            <div class="col-md-6">
                <div class="form-group">
                    <label for="exampleInputPassword1">Custom 1</label>
                    <input type="text" class="form-control" id="CustomProperty1" value ="@Model.CustomProperty1"  placeholder="Numero de tarjeta">
                </div>
                <div class="form-group">
                    <label for="ZipCode">Custom 2</label>
                    <input type="text" class="form-control" id="CustomProperty3"  value ="@Model.CustomProperty3" placeholder="Fecha de Expiracion">
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label for="exampleInputPassword1">Custom 3</label>
                    <input type="text" class="form-control" id="CustomProperty2" value ="@Model.CustomProperty2"  placeholder="Tarjeta de credito">
                </div>
                <div class="form-group">
                    <label for="ZipCode">Custom 4</label>
                    <input type="text" class="form-control" id="CustomProperty4"  value ="@Model.CustomProperty4" placeholder="Contact Id">
                </div>
            </div>
        </div>

    </div>
    <div class="col-md-6">
        <fieldset><legend class="text-primary">Respuesta del Cliente</legend></fieldset>
        <div class="row">
            <div class="col-md-6">
                <div class="form-group">
                    <label for="MaritalStatus">Respuesta</label>
                    <select class="form-control">
                        <option>Ok</option>
                        <option>Pendiente</option>
                        <option>Rechazado</option>
                    </select>
                </div>
                <div class="form-group">
                    <label for="MaritalStatus">Servicio</label>
                    <select class="form-control">
                        <option>Ok</option>
                        <option>Pendiente</option>
                        <option>Rechazado</option>
                    </select>
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label for="exampleInputPassword1">Comentarios:</label>
                    <textarea class="form-control" rows="4"></textarea>
                </div>
            </div>
        </div>

    </div>
</div>



